Age-related changes in the vaginal microbial environment of women with abnormal discharge or vulvovaginal pruritus

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type:TOHO University Scholarly Publication

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Background: To investigate age-related changes in the vaginal microbial environment, we analyzed specimens cultured from vaginal secretions of women with abnormal discharge or vulvovaginal pruritus. Methods: The detection rates of Lactobacillus, Candida, and bacteria other than Lactobacillus and anaerobic bacteria were retrospectively compared among 3393 cultures of vaginal secretions from reproductive-age (18-44 years), middle-aged (45-55 years), and older (>56 years) women who presented with abnormal vaginal discharge or vulvovaginal pruritus. Pregnant women were excluded. Results: The detection rates of bacteria (other than Lactobacillus and anaerobic bacteria) and or Candida were significantly higher in middle-aged and older women than in those of reproductive-age (85.0% and 87.7% vs 78.6%, respectively). The detection rate of Lactobacillus was 52.3% in women of reproductive-age, 35.9% in middle-aged women, and 15.6% in older women. The detection rate of Lactobacillus significantly decreased with advancing age. The overall detection rate of Candida was 22.5%; the detection frequency of Candida was significantly lower in older women than in women of reproductive-age and middle-aged women (13.8% vs 24.9% and 23.9%, respectively). We also found that the constitution of bacteria and Candida significantly differed among the 3 age groups. Conclusions: The species and frequency of bacteria and Candida in the vagina vary with age. 背景:帯下の異常や外陰部・腟の掻痒の原因となり得る,腟内細菌およびカンジダの検出頻度や検出菌種が,加齢によりどのように変化するのかを検証するため,腟分泌物培養検査の結果を分析した.対象および方法:医療センター大橋病院産婦人科外来にて帯下の異常や外陰部・腟の掻痒を訴える患者(妊婦を除く)に対して施行した腟分泌物培養検査3393 検体を性成熟期世代(18〜44 歳),更年期世代(45〜55 歳),老年期世代(56 歳以上)の3 群に分け,それらにおける検出菌種と検出割合を後方視的に比較検討した.結果:各世代における全検体中のLactobacillus および嫌気性菌を除いた細菌・カンジダが検出された割合は,性成熟期世代(78.6%)で更年期世代(85.0%)と老年期世代(87.7%)に比べ有意に低かった.Lactobacillusの検出割合は性成熟期世代(52.3%),更年期世代(35.9%),老年期世代(15.6%)と年代が上がるにつれ有意に低くなっていた.全世代におけるカンジダの検出割合は全検体中22.5% であったが,老年期世代(13.8%)では性成熟期世代(24.9%)および更年期世代(23.9%)に比べ有意に検出割合が低かった.また,検出された菌種とその割合は,細菌・カンジダともに世代ごとに大きく異なっていた.結論:帯下の異常や外陰部・腟の掻痒の原因となり得る,腟内細菌および真菌の検出頻度や菌種は,世代が変わるごとに大きく変化することが確認された.

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